Lumbar and Cervical Lordosis

Both the cervical spine (neck) and lumbar spine (lower back) naturally curve inward. However, if either location curves too far inward, the conditions are called excessive cervical lordosis or lumbar lordosis (swayback).

Note that the word "lordosis" is used to describe both the natural curve of the cervical or lumbar spine and an excessive inward curve of the spine. It is the excessive inward curve that can lead to back pain and other problems.

Cervical Lordosis

You are more likely to hear of the loss of cervical lordosis, which is when the neck becomes too straight, rather than of excessive cervical lordosis. Excessive cervical lordosis is a condition that may not even cause any pain or symptoms. However, the excess curve can be associated with a forward head position and tight muscles that can lead to pain.

Lumbar Lordosis

Too much curve in the lower spine puts extra pressure on the entire back. If you lie on a hard surface and have a space between your lower back and the surface, this may indicate lordosis. If the curve reverses itself when you bend forward, the lordosis is probably not of medical concern, especially if you are not having symptoms. If the curve does not change when you bend forward, the lordosis is fixed and may require treatment. See your doctor for a proper physical examination.

To help prevent lumbar lordosis, maintain good posture and keep the surrounding back, abdominal and buttock muscles strong and flexible. Follow these tips:

• The best sleeping position is on your back with a pillow under your knees. (If you do sleep on your stomach, place a flat pillow under your belly.)
• When sitting, keep your feet flat on the floor.
• When standing, do not lock your knees straight.
• When standing, if possible, rest one leg higher on a step to help support the lower back.
• Wear supportive shoes. High heels can throw your posture out of alignment.

Other conditions that can contribute to lumbar lordosis include:

• Achondroplasia (an inherited bone growth disorder)
• Discitis (inflammation of the intervertebral disc space)
• Kyphosis in the thoracic spine
• Obesity
• Osteoporosis
• Spondylolisthesis (slippage of the vertebrae).

Treatment for Lordosis

Treatment for lordosis may include:

• Analgesics and anti-inflammatory drugs to relieve pain
• Bracing, which in adolescents, may prevent the curve from getting worse
• Physical therapy and home exercise to build strength, flexibility and increased range of motion
• Weight loss, if needed, to take extra stress off the lower back.

One goal of treatment is to remove stress on the back from lordosis. Spine surgery is considered only if the lordosis is severe and symptoms involve nerves, or if conservative treatment has not worked.

Resources

Cedars-Sinai Staff. (n.d.). Lumbar lordosis. Retrieved March 15, 2010, from http://www.csmc.edu/5725.html

Cure-Back-Pain.org Staff. (n.d.). Cervical lordosis. Retrieved March 12, 2010, from http://www.cure-back-pain.org/cervical-lordosis.html

Regan, J. (n.d.). A closer look at lordosis. Retrieved March 12, 2010, from http://www.spineuniverse.com/conditions/closer-look-lordosis

Regan, J. (n.d.). How doctors diagnose and treat lordosis. Retrieved March 12, 2010, from http://www.spineuniverse.com/treatments/how-doctors-diagnose-treat-lordosis

University of Iowa Hospitals and Clinics Staff. (n.d.). Lumbar lordosis. Retrieved March 12, 2010, from http://www.uihealthcare.com/topics/bonesjointsmuscles/bone3435.html